Angiograms are performed to allow doctors to see if blood vessels are healthy or diseased. Most are non-invasive using duplex ultrasound, MRI or CT scanning. Conventional Angiography is more invasive as a catheter is placed into the blood vessel and contrast (dye) is injected directly. Although invasive, this technique also allows for diseased blood vessels to be treated directly at the same time, using balloon angioplasty (Figure 1) or placing a Stent (Figure 2). Narrowed or blocked arteries are stretched or re-opened. These procedures are usually performed under local anaesthetic, and are a minimally invasive means of treating blocked arteries.
Angiography and Angioplasty is performed for the treatment of peripheral arterial disease (PAD).Successful treatment restores good blood supply to the limb. In patients suffering from intermittent claudication or rest pain symptoms are resolved and quality of life restored. In those with non-healing ulcers or gangrene, treatment may avoid a requirement for amputation.
Specific Risks and Complications
- Haematoma: Bleeding at the site of arterial puncture (haematoma) which causes bruising and swelling and may necessitate an open surgical procedure to stop the bleeding or to remove collected blood clot.
- Angioplasty Failure: It is not always possible to re-open a blocked or narrowed blood vessel by means of angioplasty, if the procedures fails, symptoms will be unchanged.
- Worsening of Ischaemia: Any attempt to improve the circulation by angioplasty risks making things worse is rare instances, and on these occasions emergency surgery may be required. Worsening of the blood supply to an already compromised limb is associated with a risk of limb loss (amputation).
- Blood Vessel Rupture: In rare cases, stretching open a narrowed blood vessel by angioplasty can cause the vessel to rupture, causing potentially life threatening bleeding. In most cases when this happens the ruptured blood vessel is repaired by placing a stent, however, in some cases emergency open surgery is required.
- Allergy: Allergic reaction to the dye or contrast is a rare but potentially serious occurrence.
Angioplasty: A guide wire is passed across the narrowed or blocked segment of artery, A balloon is then inflated on the guidewire to stretch open the artery, which remains open when the balloon is withdrawn.
Angioplasty and Stenting: In some cases a Stent is placed to help keep the treated blood vessel open.